Understanding the potential role of Social Prescribing Link Workers in supporting identified needs of people with physical and mental long-term conditions: a qualitative study

BMC Primary Care Linceviciute et al. BMC Primary Care (2025) 26:372 https://doi.org/10.1186/s12875-025-02990-z Open Access RESEARCH Understanding the potential role of Social Prescribing Link Workers in supporting identified needs of people with physical and mental long-term conditions: a qualitative study Skaiste Linceviciute1* , Leire Ambrosio2* , David S. Baldwin1,3 and Mari Carmen Portillo2 Abstract Background The Social Prescribing Link Worker (SPLW) approach is a means for supporting individuals and communities with diverse needs, with its reach and impact widely recognised in health and community systems. However, SPLW support for people with long-term physical and mental health conditions (P + MH LTCs) has been variable and there are knowledge gaps such as unheard voices of those with a varied engagement in SPLW support. We undertook a study to better understand the potential relevance of SPLW support for addressing the needs of individuals with P + MH LTCs. Its aim was to explore a range of health and psychosocial needs of people living with P + MH LTCs and to examine perspectives on how the SPLW role supports the complex needs of this group. Methods A qualitative study utilising one-to-one semi-structured interviews with community dwelling adults (aged ≥ 18 years old) living with P + MH LTCs with diverse socio-demographic and clinical characteristics. Research was informed by a Patient and Public Involvement and Engagement (PPIE) group for meaningful and inclusive research activities, and qualitative data were analysed using a Framework Method. Results Analysis revealed five themes and sixteen sub-themes that collectively demonstrate the complex and shifting experience of living with P + MH LTCs. This population dealt with competing multi-layered needs, and felt that the potential role of SPLW support to mitigate some of the unmet demands of this group was not effectively carried out in practice. This meant that potential benefits were often missed. Conclusions Our findings demonstrate that this population is experiencing a substantial impact on health and wellbeing, and that there is an urgent need for integrated health and care systems that are complemented by consistent, coordinated and skilled SPLW support. Lessons learnt in this research provide new evidence and suggest directions for further research. *Correspondence: Skaiste Linceviciute Leire Ambrosio Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Linceviciute et al. BMC Primary Care (2025) 26:372 Page 2 of 20 Keywords social prescribing link worker, physical and mental long-term conditions, qualitative methods, community research Introduction Approximately 14 million people in England alone live with multiple long-term conditions (MLTCs) [1], and there is a predicted 34% increase by 2049 [2]. MLTCs can comprise physical and mental health conditions (P + MH LTCs) in the same individual [3], and have a bi-directional relationship, with a complex burden and adverse health and quality of life outcomes [4, 5]. The growing prevalence and increasing personal and collective burden of MLTCs is becoming a major public health concern, in the UK and worldwide [6, 7]. The coexistence of P + MH LTCs is associated with several sociodemographic factors including ageing, gender, and lower socioeconomic status (particularly for individuals living in the most deprived areas and communities, and/or facing unemployment), and also linked to lifestyle choices such as tobacco and alcohol use, poor physical activity and environmental exposures[8]. These complex social and cultural determinants and the demands of managing MLTCs together result in a greater use of healthcare services, many of which are not adequately equipped to support non-medical needs and challenges [9–11]. It is a continually shifting landscape featuring competing demands and priorities, and affected patients require sustainable, effective and relevant support [12–15]. A ‘social prescribing’ approach has been presented as a means for addressing a range of non-medical, socioeconomic and health related needs in people with LTCs, through a ‘community referral’ [16, 17]. Social prescribing is a mechanism that involves bridging health and social care services through partnership with voluntary and community structures to connect patients to local non-clinical services, so supporting them with a range of psychosocial and practical needs [18, 19]. Embedded in primary care or community settings, it is typically facilitated by a ‘Social Prescribing Link Worker’ (SPLW) who co-designs a personalised and meaningful social prescription based on a ‘what matters to you discussion’ and for the type of support thought to be needed [20–23]. Evidence around social prescribing for supporting individuals with LTCs has grown steadily [24–28], including its reach and positive impact in the wider community [29, 30]; particularly for studying patient and systemlevel outcomes including mental health, lifestyle, ‘belonging’ and healthcare utilisation [31]. However, systematic reviews have demonstrated that the way in which social prescribing is conceptualised, implemented, assessed and evidenced is highly variable, with limitations and gaps in knowledge [32–36]. A recently published book on ‘Social Prescribing Policy, Research and Practice’ made up of evidence and lessons learnt by leading researchers in the field called for comprehensive evidence expansion, some of which relates to the need for better understanding of cohorts that engage or do not engage with social prescribing. This includes but is not limited to, reasons and behaviours around those processes to ensure that social prescribing programmes, and particularly Link Workers delivering it, are appropriately equipped to support those in most need [37–39]. The authors pointed out that there are inconsistencies in access to social prescribing and a lack of clarity in how social prescribing support is configured to meet the needs of certain groups [38, 39], such as wide-ranging patients with LTCs [25, 26, 40–42]. This particularl (...truncated)